With regard to the closure of services at Ilkeston Community Hospital, the reason is clear, lack of finance.
The cause of this lack of finance, affecting not just the NHS, but the public sector in general, is the appetite of the present Conservative and previous Labour governments for Private Finance Initiatives, or PFIs. There are currently 717 PFI contracts, applied to the provision of hospitals. police stations, schools, and other public sector buildings.
The Guardian newspaper, in an article dated the July 5, 2012, estimates that these PFI contracts will ultimately cost £300bn, with repayments to contractors costing £10bn per year by 2017 to 2018.